tbuckley/cabot-search huggingface dataset:
POS0582-PARE MEASURES FOR IMPROVING FEEDBACK TO PATIENT RESEARCH PARTNERS IN PARTICIPATORY RESEARCH PROJECTS
Authors: J. Clausen
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The acceptance of participatory research has increased in recent years. However, discussions during the meeting of the EULAR Study Group for Collaborative Research (EULAR conference 2022, Copenhagen) revealed the risk of mere "tokenism" in participatory research projects. In Germany, with more than 60 participatory research projects in the field of rheumatology, "tokenism" is also a matter of discussion in this country. <h3>Objectives</h3> One aspect of tokenism is that patient research partners (PRPs) are involved in the preparation of the application at the beginning of a research project, but they are neglected after the funding application has been submitted, resulting in a lack of feedback from the research projects. The German Rheumatism League (Deutsche Rheuma-Liga, DRL) tried to find ways to improve and uphold continuous communication between scientists and PRPs during all phases of research projects. <h3>Methods</h3> In May 2022, the DRL conducted a survey among the active PRPs on (a) how regularly the PRPs are informed about the status of the research projects, (b) whether contact is usually unsolicited and (c), how the communication was rated overall. Based on the evaluation, measures were discussed to improve communication, and supporting tools were developed. A new survey will be carried out after one year. <h3>Results</h3> In May 2022, the PRPs had not received any information from the research projects for an average of 124 days. However, the timelines varied greatly between ongoing projects (on average 77 days) and for those projects whose applications were only under submission and were waiting for the confirmation of funding ("application phase"; on average 280 days). In about 40% of all projects, the overall flow of information was rated as "bad" or "very bad". Based on these results, the DRL discussed measures with the PRPs as to what adequate communication looks like and how it can be guaranteed that it takes place. Supporting tools were developed and incorporated into the process of coordinating the PRPs. In addition, the DRL discussed what appropriate consequences might be put in place for projects that hesitate to adapt their communication behaviour. <h3>Conclusion</h3> The long absence of any communication, especially during the "application phase", was assessed as unacceptable. In a follow-up survey with PRPs, in May2023, we shall evaluate the impact of the developed tools and discuss and act upon the findings. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0395 DIFFERENCE IN PREDICTORS OF FRACTURES IN PATIENTS WITH SEVERE VERSUS ESTABLISHED OSTEOPOROSIS
Authors: U. Nadeem, Z. Sultan, M. Bukhari
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The FRAX™ risk assessment tool is utilised to predict fracture risk in patients with poor bone health. It uses the bone mineral density (BMD) at the non-dominant femoral neck. The performance of the tool in predicting fractures with worsening BMD has not been examined. <h3>Objectives</h3> The aim of this study was to investigate whether different factors within the FRAX™ tool are more predictive of severe osteoporosis; defined by a T score of -3.5 and below, compared to patients with a t score of -2.5 to -3.49. <h3>Methods</h3> Two patient cohorts were identified from patients referred for routine DEXA scans between 2004 and 2019, in the Northwest of England. The first cohort (group A) consisted of patients with a T score between -2.5 and -3.5 and the second cohort (group B) consisted of patients with a T score of -3.5 and below. The FRAX risk factors and the BMD data were analysed, using a Student's T test for continuous variables and a Chi Squared test for categorical variables. Univariate and multivariate logistic regression models were also fitted examining the differences in the FRAX™ risk factors and severe osteoporosis prediction. The sites measured included an average of L1-L4, right and left femoral neck in which their BMD mean and both their respective BMD totals were analysed. FRAX™ risk factors included age, weight, height, BMI, sex, previous fracture, parent fractured hip, smoking, steroid use, rheumatoid arthritis, alcohol consumption and coeliac disease/malabsorption. <h3>Results</h3> 31,547 patients were included in the analysis, with a mean age of 64.9 years (SD = 12.9). The number of individuals in group A were 4,714 (81.54%) and 1,067 (18.46%) in group B. Table one depicts the differences in the FRAX™ risk factors between the two groups and the odds ratios. Age, weight, height, BMI and current smoking were statistically significant in predicting severe osteoporosis. Lower weight, height and BMI was associated with group B. In addition, increased age and current smoking was also associated with group B. There was no significant difference between group A and B in regard to sex, previous fracture, parent fractured hip, steroid use, rheumatoid arthritis, alcohol consumption or coeliac disease/malabsorption. <h3>Conclusion</h3> The results of this study indicate that certain risk factors used in the FRAX™ scoring are more predictive of a severe osteoporosis than others. In addition, research providing insight into utilising FRAX™ variables in fracture prediction in patients with severe osteoporosis will provide valuable insight. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0763 AN EVALUATION OF THE EFFICIENCY OF METHOTREXATE IN THE TREATMENT OF JUVENILE ENTHESITIS RELATED ARTHRITIS
Authors: L. Krämer, I. Foeldvari
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Methotrexate (MTX) is quiet commonly used to treat all subtypes of juvenile idiopathic arthritis (JIA). Despite that, there are no studies on the efficiency of MTX treatment in juvenile enthesitis related arthritis (ERA). <h3>Objectives</h3> This study aims to evaluate the efficacy of MTX treatment in children with juvenile arthritis of the ERA subtype. <h3>Methods</h3> We conducted a retrospective chart review from January 2017 to December 2021 of all patients who received MTX for at least 3 months. The clinical manifestation of the ERA was determined by using JADAS and the JSpADA. Good therapeutic response was defined by a reduction of the JSpADA by 0,8 points or more. A JADAS under &lt; 2 was considered minimal disease activity, whereas a JADAS &lt; 1 was interpreted as inactive disease. <h3>Results</h3> We found 188 patients in whom MTX was initiated, 117 (62,23 %) of these patients were treated with MTX for at least three months and therefore fulfilled the criteria for this analysis. At all follow-ups, the patients showed a significant reduction in both scores compared to the start (see Table 1). After three months 49,57 % of the participating patients were considered good responders, after twelve months it was 70 %. Half of the followed patients achieved the state of remission after twelve months, another 12,82 % showed only minimal disease activity at this point. <h3>Conclusion</h3> This study shows the efficacy of MTX as a first-line therapy for the treatment of children with ERA. A comparative study with Sulfasalazine would be interesting. <h3>References</h3> [1]Weiss PF, Colbert RA, Xiao R, Feudtner C, Beukelman T, DeWitt EM, et al. Development and retrospective validation of the juvenile spondyloarthritis disease activity index. Arthritis Care Res (Hoboken). 2014;66(12):1775-82. [2]Consolaro A, Ruperto N, Bazso A, Pistorio A, Magni-Manzoni S, Filocamo G, et al. Development and validation of a composite disease activity score for juvenile idiopathic arthritis. Arthritis Rheum. 2009;61(5):658-66. [3]Consolaro A, Bracciolini G, Ruperto N, Pistorio A, Magni-Manzoni S, Malattia C, et al. Remission, minimal disease activity, and acceptable symptom state in juvenile idiopathic arthritis: defining criteria based on the juvenile arthritis disease activity score. Arthritis Rheum. 2012;64(7):2366-74. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0399 THE ION CHANNEL TRPV4 PARTICIPATES IN THE CARTILAGE PROTECTION OF IGURATIMOD ON KNEE OSTEOARTHRITIS
Authors: L. Wang, Y. Wei, R. Ma, C. Cang, X. Li
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Osteoarthritis (OA) is the leading cause of disability for bone and joint diseases. Cartilage injury is its pathological basis. There is a lack of therapeutic drugs with clear cartilage protection in clinic. Iguratimod (IGU) has cartilage protection effect in the treatment of rheumatoid arthritis, but it is not clear whether it also has cartilage protection effect on OA. <h3>Objectives</h3> To investigated the efficacy and mechanism of Iguratimod (IGU) on cartilage protection effect on knee osteoarthritis (OA). <h3>Methods</h3> Type VII collagenase was injected into the knee joint cavity of C57BL6/N rats to establish a model of CIOA (Collagenase-induced Osteoarthritis), to establish the model of osteoarthritis, followed by IGU given by intragastrium at 10mg/kg. μCT and Immunohistochemistry (IHC) were used to evaluate the structural changes of OA knee joint, the degree of destruction of knee cartilage layer and subchondral bone. IHC and qPCR were used to evaluated the expression of TPRV4 in chondrocytes of OA rats. Chondrocytes were processed by IGU at the cellular level, and the concentration of glycosaminoglycan secreted and the expression of chondrogenic differentiation factor in cells were further detected. TRPV4 ion channel inhibitor and interfering RNA technology were used to verify whether TRPV4 was involved in the effect of IGU on cartilage. <h3>Results</h3> It was found that IGU could change the pain sensitivity of OA model rats and effectively reduce the pain of OA rats. μCT showed that IGU could effectively inhibit the subchondral bone injury of knee joint in OA rats; Toluidine blue staining and Safranin O-Fast Green staining of rats knee joint also showed that IGU treatment could delay the degeneration of knee cartilage of rats with OA. At the cellular level, it was found by qPCR that IGU could effectively promote the expression of mRNA levels of Sox9 and Col2a, markers of chondrogenesis, in chondrocytes. Alcian blue staining also showed that IGU promoted chondrocyte secretion of glycosaminoglycan; Moreover, the results of scratch experiment also showed that IGU promoted the migration of chondrocytes. The results addressed above all indicated that IGU could promote the differentiation of chondrocytes. The expression of transient receptor point vanillin 4 (TRPV4) in OA rats chondrocytes in the treatment group of IGU was increased. We used ion channel inhibitors and interfering RNA technology to show that IGU played a role in delaying cartilage damage, promoting cartilage differentiation and migration by regulating the function of TRPV4. <h3>Conclusion</h3> IGU can effectively alleviate the pain of OA model rats, and exert cartilage protection by regulating TRPV4. The results offer new treatment options for osteoarthritis. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0766 CIRCULATING SOLUBLE UROKINASE PLASMINOGEN ACTIVATOR RECEPTOR (SUPAR) ASSOCIATES WITH JOINT DESTRUCTION IN JUVENILE IDIOPATHIC ARTHRITIS: A CASE-CONTROL STUDY WITH LONGITUDINAL FOLLOW-UP
Authors: P. Lewander, C. Dahle, L. Wirestam, J. Wetterö, C. Sjöwall
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Reliable biomarkers in the early stages of juvenile idiopathic arthritis (JIA) are scarce. The disease heterogeneity makes it clinically challenging to predict the risk of future permanent joint damage. Some indicators of poor outcome have been identified, e.g. rheumatoid factor (RF) and antibodies against cyclic citrullinated peptides (anti-CCP), but additional biomarkers with predictive potential are warranted in order to start optimal treatment before tissue damage occurs. The soluble urokinase plasminogen activator receptor (suPAR) has been reported as an easily measurable biomarker for prognosis and severity in several diseases, including adult rheumatoid arthritis, systemic lupus erythematosus and other inflammatory conditions [1]. However, to our knowledge, suPAR has never been studied in JIA. <h3>Objectives</h3> We asked whether suPAR could predict a more severe course with erosions in JIA. <h3>Methods</h3> 51 well-characterized patients with recent-onset or established JIA and 50 age- and sex-matched healthy control subjects were included. Blood sampling was performed at inclusion and sera were stored for later analysis of suPAR by suPARnostic ELISA (Virogates, Birkeröd, Denmark). The patients were carefully followed over 3 years and erythrocyte sedimentation rate, C-reactive protein, RF, anti-CCP and antinuclear antibodies were analyzed as part of clinical routine. Signs of joint destructions were evaluated by radiographic investigation of affected joints. Data was evaluated using non-parametrical statistical methods. <h3>Results</h3> Overall, the levels of suPAR did not differ significantly between JIA and controls (Figure 1). Still, the subgroup of subjects with polyarticular disease showed higher suPAR than the controls (p=0.013). In addition, elevated suPAR levels were associated with joint erosions (p=0.022). In two individuals with erosions, high levels of suPAR were found despite absence of RF and anti-CCP. <h3>Conclusion</h3> We present new data on the biomarker suPAR in JIA. The results indicate that, in addition to RF and anti-CCP, analysis of suPAR could be of additional value in predicting the risk of joint erosions. Early analysis of suPAR could potentially guide treatment decision-making in JIA, but our findings call for confirmation in larger cohorts. <h3>Reference</h3> [1]Rasmussen LJH, Petersen JEV, Eugen-Olsen J. Soluble Urokinase Plasminogen Activator Receptor (suPAR) as a Biomarker of Systemic Chronic Inflammation. <i>Front Immunol</i> 2021 Dec 2;12:780641. doi: 10.3389/fimmu.2021.780641. PMID: 34925360; PMCID: PMC8674945. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0561 THE LEAKY PIPELINE IN CLINICAL RHEUMATOLOGY ACROSS EUROPE – RESULTS FROM AN ONLINE SURVEY
Authors: J. Sautner, I. Grabner, A. Posch, C. Duftner
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> While more than 50% of medical students and residents are women, their proportion drastically diminishes within higher ranks and leadership roles, a phenomenon also known as the "leaky pipeline". <h3>Objectives</h3> We aimed to evaluate the leaky pipeline among rheumatologists across Europe and to assess determinants inducing rheumatologists to leave hospitals. <h3>Methods</h3> Experts in the field of economics developed a questionnaire (50 thematic blocks, containing 172 single items) with relevance to the leaky pipeline. with scientific focus on the leaky pipeline among rheumatologists, which was distributed electronically by national scientific societies of EULAR countries and by individual contacts. We performed common factor analysis, univariate t-tests and multivariate regression analyses to appraise our dataset using Stata Version 17 (StataCorp, Texas, USA). <h3>Results</h3> 311 hospital-based rheumatologists from 23/45 EULAR countries (52.7% females, 47.3% males) responded to the questionnaire. The phenomenon of the leaky pipeline was present for the entire sample. Of 64% female rheumatologists only 34.2% departments' directors were female, with noteworthy regional differences (Table 1). Female doctors reported higher intentions to leave their hospitals (β = 0.28, p &lt; 0.05) and lower commitment towards their current organization (β = -0.34, p &lt; 0.05) when compared to males. Additionally, women reported lower levels of job satisfaction (β = -0.26, p &lt; 0.10), promotion justice (β = -0.55, p &lt; 0.01), and career perspectives (β = -0.15, p &lt; 0.10, one-tailed) than men, explaining their lower organizational commitment. <h3>Conclusion</h3> Female rheumatologists perceive worse job opportunities and satisfaction than males. Many reasons for the leaky pipeline are beyond the control of organizations. By our results, organizations should be encouraged to reconsider and adjust their performance management practices enabling an equitable work environment. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Judith Sautner Grant/research support from: Eli-Lilly, Pfizer, UCB supported the technical operationalization of the questionnaire, Isabella Grabner Grant/research support from: Eli-Lilly, Pfizer, UCB supported the technical operationalization of the questionnaire, Arthur Posch Grant/research support from: Eli-Lilly, Pfizer, UCB supported the technical operationalization of the questionnaire, Christina Duftner Speakers bureau: Abbvie, AOP Orphan, Astra-Zeneca, Bristol-Myers-Squibb, Eli-Lilly, Janssen, Galapagos, Merck-Sharp-Dohme, Novartis, Pfizer, Roche, Sandoz, UCB, Vifor, all unrelated to this manuscript, Grant/research support from: Eli-Lilly, Pfizer, UCB supported the technical operationalization of the questionnaire.
POS0732 PERFORMANCE OF THE 2022 ACR/EULAR CLASSIFICATION CRITERIA FOR GIANT CELL ARTERITIS IN ROUTINE CLINICAL CARE
Authors: J. Molina Collada, I. Castrejon, I. Monjo, E. Fernández-Fernández, G. Torres Ortiz, J. M. Alvaro-Gracia, E. De Miguel
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The 2022 ACR/EULAR giant cell arteritis (GCA) classification criteria have been designed to improve diagnostic accuracy incorporating vascular imaging modalities and potential large vessel (LV) involvement. These new criteria have been validated in an independent set of patients and controls, with a sensitivity of 87.0% and a specificity of 94.8%, but not tested in routine care. <h3>Objectives</h3> Our objective is to examine the performance of the new 2022 ACR/EULAR GCA classification criteria in this clinical scenario. <h3>Methods</h3> Multicentric retrospective observational study of patients referred to our ultrasound (US) fast track clinic over a 4-year period. The gold standard for GCA diagnosis was clinical confirmation after 6 months of follow-up. Patients with GCA were compared with unselected controls referred to our clinic with suspected GCA. All patients underwent US exam of temporal and extracranial arteries (carotid, subclavian and axillary) within 24-48 hours at baseline. FDG-PET/CT was performed according to standard clinician criteria. Following the new 2022 GCA ACR/EULAR classification criteria, the total score for the 10 items included in the criteria was calculated, with a total cut-off ≥ 6 for the classification of GCA. The performance of these criteria was evaluated in all GCA patients across different subsets of the disease. <h3>Results</h3> A total of 319 patients (188 cases and 131 controls) were included for analysis (mean age 76 years, 58.9% females). Patients with GCA and controls differed in age (78.2 vs 72.9, p&lt;0.001) and sex (females 53.2% vs 67.2%, p=0.013). The diagnostic accuracy of the 2022 ACR/EULAR GCA classification criteria and the previous 1990 ACR GCA classification criteria in different subsets of patients is shown in Table 1. Overall, the new criteria had a sensitivity of 92.6% and a specificity of 74%, using GCA clinical diagnosis as an external criterion and the area under the curve (AUC) was 0.932 (95% CI 0.903 to 0.960). Isolated LV-GCA showed a sensitivity of 62.2% and a specificity of 74% (AUC 0.696 [0.596 – 0.796]) and biopsy-proven GCA showed a sensitivity of 100% and a specificity of 74% (AUC 0.992 [0.981 – 1]). <h3>Conclusion</h3> The new 2022 ACR/EULAR GCA classification criteria showed good diagnostic accuracy of patients with suspected GCA under routine care, and a substantial improvement upon the sensitivity and specificity of the 1990 ACR GCA classification criteria in all patients subsets. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0658 ANKYLOSING SPONDYLITIS IS ASSOCIATED WITH INCREASED PREVALENCE OF VALVULAR HEART DISEASES: A POPULATION BASED STUDY
Authors: S. Eid, K. Sharif, L. Fisher, Y. S. Patt, H. Amital, A. Watad
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Ankylosing spondylitis (AS) is a chronic inflammatory arthritis primarily affecting the sacroiliac joint and axial skeleton with associated extraarticular involvement including cardiovascular system disease including aortic value disease with variable reported prevalence. <h3>Objectives</h3> The aim of this study is to determine the prevalence of heart valve disorders in AS patients. <h3>Methods</h3> A retrospective, population-based, cross-sectional study retrieved from the Clalit Health Services (CHS) registry. Cases were defined as having AS, whereas controls were age- and sex- frequency matched in a ratio of 5:1. The prevalence of valvular heart diseases was compared between the two groups, a multivariate logistic regression model was applied to estimate the association after controlling for potential confounders. <h3>Results</h3> We included 4,082 AS patients and 20,397 age- and sex- frequency matched controls. AS patients had a significantly higher prevalence of cardiovascular risk factors (p&lt;0.001) and a higher prevalence of valvular heart disease. In the multivariate logistic regression model, adjusting for multiple confounding factors, AS was independently associated with aortic stenosis (OR 2.25, 95% CI 1.57-3.23, p&lt;0.001), aortic insufficiency (OR 2.44, 95%CI 1.5-3.94, p&lt;0.001), mitral insufficiency (OR 1.75, 95%CI 1.17-2.61, p&lt;0.001) but not mitral stenosis (OR 1.31, 95% CI 0.6-2.7, p=0.47). <h3>Conclusion</h3> Our study reports the increased risk of valvular heart diseases in patients with AS possibly due to the inflammatory milieu associated with the disease process and the result of biomechanical stress affecting the enthesis-like valvular structures. <h3>Reference</h3> [1]Dubash S, McGonagle D, Marzo-Ortega H. New advances in the understanding and treatment of axial spondyloarthritis: from chance to choice. Ther Adv Chronic Dis. 2018;9:77-87 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.